Increased difficulty with eating and swallowing is one of the signs that an Alzheimer's patient has moved into the final stages of the disease. He or she may tend to choke on food and drink, running the risk of a respiratory infection. He or she may lose interest in food or forget how to swallow. These signs mark the end of a very sad and long disease process. By this point the patient is totally dependent on others for care, incontinent, unable to recognize family or to speak intelligibly and failing to thrive.

Some may choose to treat the reduction in food and fluid intake with a feeding tube. Family, doctors, or nurses may say they do not want the patient to "starve" to death. Providing tube feeding is certainly an acceptable way to provide care.

However, the patient isn't feeling any hunger. The dying is part of a very tragic disease, and the inability to eat is an expected part of its last stages. Inserting a tube will not stop the progression of the fatal disease, though it might prolong or hasten the dying process. Since dying without hydration is comfortable, many loved ones choose to forgo the tube feeding. Offer the patient whatever he or she can tolerate by spoon feeding and drinking. Sips of water and ice chips can relieve dry mouth. This decision poses the kind of perplexing situation that may become more clear as society has more experience of it.